MEDICARE: AARON J KILTS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY003445	GA

General Provider Information

NPI Number	:	1972801942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON J KILTS PSY.D.

Provider Business Mailing Address
First Line	:	1961 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-1842
Country	:	US
Telephone Number	:	678-686-5941
Fax Number	:	678-904-4460

Provider Business Practice Location Address
First Line	:	1903 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-4119
Country	:	US
Telephone Number	:	678-686-5941
Fax Number	:	678-904-4460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2011
Last Update Date	:	03/01/2011

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